{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,7]],"date-time":"2026-09-07T02:16:44Z","timestamp":1788747404149,"version":"build-2803163510"},"reference-count":30,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2021,3,23]],"date-time":"2021-03-23T00:00:00Z","timestamp":1616457600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Clinical Transplantation"],"published-print":{"date-parts":[[2021,6]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>Renal transplant recipients remain at risk of delayed\u2010onset cytomegalovirus (CMV) infection occurring beyond a complete course of prophylaxis. In this retrospective cohort, all 278 patients who received renal allografts from deceased donors from 2014 to 2016 were followed until September 1, 2019. We determined the effect of early\u2013vs late\u2010onset acute rejection (EAR vs LAR [ie, occurring beyond 12\u00a0months after transplantation]) on CMV infection and subsequently long\u2010term allograft outcome.<\/jats:p><jats:p>Median (IQR) duration of follow\u2010up was 1186.0 (904.7\u20101531.2) days. Seventy patients including 49 patients with EAR and 21 with LAR received augmented immunosuppression. In the same interval, 40 patients developed CMV infection (36 patients beyond 90\u00a0days after transplantation [90%]). In logistic regression analysis, D+\/R\u2010 CMV serostatus (OR: 5.5, 95% CI: 2.5\u201012.2) and LAR (OR: 7.9, 95% CI: 2.8\u201022.2) significantly increased the risk of CMV infection. In Cox proportional hazard model, delayed\u2010onset CMV infection (HR: 2.51, 95% CI: 1.08\u20105.86) and LAR (HR: 5.46, 95% CI: 2.26\u201013.14) significantly increased the risk of allograft loss.<\/jats:p><jats:p>Patients with LAR are at risk of late\u2010onset CMV infection. Post\u2010LAR, targeted prophylaxis may reduce the risk of CMV infection and subsequently allograft loss. Further studies are required to demonstrate the effect of targeted prophylaxis following LAR.<\/jats:p>","DOI":"10.1111\/ctr.14285","type":"journal-article","created":{"date-parts":[[2021,3,13]],"date-time":"2021-03-13T16:57:32Z","timestamp":1615654652000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":6,"title":["Late\u2010onset allograft rejection, cytomegalovirus infection, and renal allograft loss: Is anti\u2010CMV prophylaxis required following late\u2010onset allograft rejection?"],"prefix":"10.1111","volume":"35","author":[{"given":"Mohammadreza","family":"Rahimishahmirzadi","sequence":"first","affiliation":[{"name":"Multiorgan Transplant Program London Health Sciences Centre Western University London ON Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anthony M.","family":"Jevnikar","sequence":"additional","affiliation":[{"name":"Multiorgan Transplant Program London Health Sciences Centre Western University London ON Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrew A.","family":"House","sequence":"additional","affiliation":[{"name":"Multiorgan Transplant Program London Health Sciences Centre Western University London ON Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9089-6933","authenticated-orcid":false,"given":"Patrick P.","family":"Luke","sequence":"additional","affiliation":[{"name":"Multiorgan Transplant Program London Health Sciences Centre Western University London ON Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Atul","family":"Humar","sequence":"additional","affiliation":[{"name":"Division of Infectious Diseases Transplant Infectious Diseases Program University Health Network Toronto ON Canada"},{"name":"Department of Medicine University of Toronto Toronto ON Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael S.","family":"Silverman","sequence":"additional","affiliation":[{"name":"Division of Infectious Diseases Department of Medicine Western University London ON Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sarah M.","family":"Shalhoub","sequence":"additional","affiliation":[{"name":"Multiorgan Transplant Program London Health Sciences Centre Western University London ON Canada"},{"name":"Division of Infectious Diseases Department of Medicine Western University London ON Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7979-2458","authenticated-orcid":false,"given":"Seyed M.","family":"Hosseini\u2010Moghaddam","sequence":"additional","affiliation":[{"name":"Multiorgan Transplant Program London Health Sciences Centre Western University London ON Canada"},{"name":"Division of Infectious Diseases Department of Medicine Western University London ON Canada"},{"name":"Division of Infectious Diseases Transplant Infectious Diseases Program University Health Network Toronto ON Canada"},{"name":"Department of Medicine University of Toronto Toronto ON Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2021,3,23]]},"reference":[{"key":"e_1_2_8_2_1","doi-asserted-by":"publisher","DOI":"10.1097\/TP.0000000000002191"},{"key":"e_1_2_8_3_1","doi-asserted-by":"publisher","DOI":"10.1111\/ctr.13512"},{"key":"e_1_2_8_4_1","doi-asserted-by":"publisher","DOI":"10.1111\/ajt.12103"},{"key":"e_1_2_8_5_1","doi-asserted-by":"publisher","DOI":"10.1097\/TP.0b013e3181ff1493"},{"key":"e_1_2_8_6_1","doi-asserted-by":"publisher","DOI":"10.6061\/clinics\/2015(07)09"},{"key":"e_1_2_8_7_1","doi-asserted-by":"publisher","DOI":"10.1038\/ki.2009.377"},{"key":"e_1_2_8_8_1","doi-asserted-by":"publisher","DOI":"10.1034\/j.1399-0012.2001.150401.x"},{"key":"e_1_2_8_9_1","doi-asserted-by":"publisher","DOI":"10.1097\/TP.0b013e3181661695"},{"key":"e_1_2_8_10_1","doi-asserted-by":"publisher","DOI":"10.1097\/01.TP.0000041722.34000.21"},{"key":"e_1_2_8_11_1","doi-asserted-by":"publisher","DOI":"10.1097\/TP.0b013e318259407f"},{"key":"e_1_2_8_12_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1600-6143.2009.03007.x"},{"key":"e_1_2_8_13_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1600-6143.2011.03840.x"},{"key":"e_1_2_8_14_1","doi-asserted-by":"publisher","DOI":"10.1086\/324516"},{"key":"e_1_2_8_15_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.krcp.2015.06.003"},{"key":"e_1_2_8_16_1","unstructured":"Ministry of Health.Exceptional access program telephone request service reimbursement criteria;2012.https:\/\/collections.ola.org\/mon\/28002\/319434.pdf. 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